Australian medical schools and colleges working with developing countries

Faculty of Health Sciences, University of Adelaide

Two general practice academics are establishing a department of general practice in Dharan, in eastern Nepal. They have had extensive previous experience in primary healthcare in Kathmandu, as well as in rural and urban general practice and Indigenous health in South Australia. Since January 2002, they have been at the BP Koirala Institute of Health Science at Dharan, teaching undergraduate students and creating a postgraduate training program in general practice (MD in Family Medicine). This is only the second postgraduate training program established for primary healthcare in Nepal. Adelaide University is providing support, including a teaching visit, a conference presentation and a planned three-month sabbatical exchange to Nepal in 2003.

School of Medicine, Flinders University

Flinders' Rural and Remote Community Clinical School and Office of Education are assisting in medical education upskilling of Thai doctors, who, in turn, will be involved in a Thai government program aimed at overcoming a shortage of rural doctors. Over 10 years, 3000 extra students will be enrolled in Thai medical schools, and receive their clinical education in rural government hospitals. They will then be bonded to work in their local areas for three years after graduation.

In Cambodia, the Director of the Rural and Remote Community Clinical School at Flinders is the delegation leader of an AusAID-funded project aimed at empowering the emerging Cambodian Medical Association to develop an Accreditation and Continuing Medical Education Program for its rural doctors. In East Timor, the Head of the Northern Territory Clinical School has acted as an advisor to the East Timor government on paediatric services and medical education.

From 2003, Flinders will be offering a Master in Hospital Management degree in association with Nankai University in China, as there are no formal qualifications in health service or hospital management in that part of China.

Finally, the Department of Medical Imaging has been involved in the training of radiologists from several developing countries.

Faculty of Medicine, Health and Molecular Sciences, James Cook University

The Faculty is conducting operational research to assist the government of Papua New Guinea (PNG) in investigating disease outbreak, and is also involved in a two-decade longitudinal study of PNG's epidemiological transition from a predominance of infectious to non-communicable diseases.

A Lymphatic Filariasis Program in the Pacific Islands (in partnership with national ministries of health) has a strong capacity-building component for a number of countries, including the Federated States of Micronesia, Tuvalu, Fiji and Nieue. The program includes investigation of epidemics, development of improved diagnostic tests and vector control methods, and novel surveillance methods. An additional initiative involving Fiji is a protocol being developed to provide PhD scholarships for staff members of the Fiji School of Medicine.

In East Timor, the Faculty is involved in World Health Organization research into intestinal helminths and lymphatic filariasis, including onsite training of laboratory staff in parasitology.

University of Melbourne School of Medicine of the Faculty of Medicine, Dentistry and Health Sciences

The School is a founding partner of the International Medical University in Malaysia, and each year takes up to 12 students into third year to complete their training at the University of Melbourne. In a separate arrangement, from 2003, 20 Malaysian students each year will be sponsored by their government to undertake a bridging program before commencing medical studies at the School.

Since 2000, one to five students per year have been sponsored by the government of Botswana to enter the Melbourne University medical course, after two years of premedical science at the University of Botswana.

Other projects in Indonesia and Malaysia will aid existing and new medical schools in curriculum development, supply curricular materials and foster research collaboration and staff and student exchange.

The School has 71 international higher-degree research students and 36 international higher-degree coursework students. Most of the latter are undertaking Master of Public Health degrees funded by AusAID.

Finally, the Faculty contributes to an AusAID-funded program in Fiji for the development of postgraduate programs at the Fiji School of Medicine.

Faculty of Medicine, Nursing and Health Sciences, Monash University

Students from developing countries undertake postgraduate degrees at the Faculty. The 2001 cohort included students from Bangladesh (3), Cambodia (2), China (1), Fiji (3), India (8), Indonesia (28), Kenya (1), Lebanon (1), Malaysia (32), Mexico (1), Nigeria (2), Pakistan (1), Philippines (1), Sri Lanka (1) and Thailand (4). In addition, the School of Nursing has been managing a $1.2 million AusAID project to deliver the Bachelor of Nursing (Post Registration) by distance education to 40 nurses in eight locations in PNG.

In 2000–2001, the Department of Epidemiology and Preventive Medicine delivered a Fellowship Program in the Master of Public Health Services Management to 25 Indonesian Ministry of Health officials. The program was funded by the Asian Development Bank for $1.7 million.

In 2001, the Department of Epidemiology and Preventive Medicine, in collaboration with George Washington University (USA), inaugurated a Master of Health Science Management course at the Monash University campus in Malaysia.

University of Queensland Faculty of Health Sciences

Over the past 20 years, 500 graduates from 30 countries have been trained in the areas of tropical health and nutrition. In addition, to assist with capacity building in community nutrition, 40 Indonesian graduates have been trained in various areas of community nutrition.

Links with PNG include bringing medical, nursing and other allied health workers to Australia for short courses, and working with the University of PNG in community medicine and curriculum development.

The Faculty has also established close relationships with several medical schools in China (Wuhan, Shanghai and Wenzhuo), including the training of PhD students, whereas student exchanges and PhD training have been used to develop programs for health service delivery in Cambodia.

Joint programs with the Queensland Institute of Medical Research include a program for the control of dengue in Vietnam, modelling of different interventions in schistosomiasis control, and a vaccine trial for acute respiratory disease in the Philippines.

Faculty of Medicine, University of Sydney

The Faculty has a Masters/Graduate Diploma of Public International Health which was established in 2000 to meet a demand, both in Australia and internationally, for high quality public health training in resource-poor settings. Since 2000, the program has grown from 13 students to the 95 students currently enrolled. Since the course's inception, 42% of the students have come from developing countries, including China (4), Mongolia (2), Vietnam (7), Cambodia (2), Philippines (3), Thailand (2), Burma (1), Malaysia (1), Bangladesh (6), India (1), Nepal (1) and Bhutan (2), sub-Saharan Africa (4), the Middle East (1) and Central and South America (1).

This program aims to provide students with skills in public health education, research and practice appropriate for developing countries. Students are trained in areas such as disease priorities, health and development, international health organisations, as well as in epidemiology, biostatistics and social science methods. Students can choose to specialise in areas such as project management, infectious and non-communicable disease control, health promotion, maternal and child health, health and culture. Most of the students from developing countries return to their own countries to provide public health expertise to governments and agencies.

University of Tasmania School of Medicine

The School has accepted international students since the 1970s. Most are from Malaysia, with recent smaller numbers from Botswana. Currently, the School admits up to 20 international students into the first year of the medical course.

The School formed a medical school partnership with the International Medical University, Kuala Lumpur, Malaysia, in 2000, and currently takes five students per year into the fourth year of the medical program.

The School also has a partnership with the Kunming Medical College, Yunnan Province, China, providing elective exchange programs in both directions, as well as postgraduate training and collaborative research.

In 2000, two scholarships for study in cardiovascular medicine in the United Kingdom were provided to University of Tasmania graduates from Malaysia and Sri Lanka. The recipients will return to their countries with postgraduate training in paediatric cardiology and management of ischaemic heart disease.

Since 1984, a number of students with AusAID or other support have had postgraduate training in cardiovascular medicine, surgery, obstetrics and gynaecology, and through the Menzies Centre for Population Health Research (China, 4; Laos, 2; Thailand, 2; and Sri Lanka, 1).

Faculty of Medicine and Dentistry, University of Western Australia

In 2000, 114 East Timorese medical students were forced to discontinue their medical studies at Indonesian universities. The university, together with the Committee of Deans of Australian Medical Schools and the colleges, is attempting to help these students complete their training and support the professional development of junior doctors.

With the World Health Organization, the Mental Health Epidemiology Unit has organised training courses for over 400 participants from Vietnam, China, Bulgaria and Russia on the International Classification of Diseases and measurement instrumentation in epidemiological research on mental disorders.

The Centre of Vision Sciences, Lions Eye Institute and Universitas Airlangga (Indonesia) have developed joint postgraduate teaching programs in Surabaya, Indonesia. Up to 25% of all Indonesian ophthalmologists have attended exchange information programs on practical diagnosis and treatment of eye diseases causing blindness.

Australian and New Zealand College of Anaesthetists

Fellows of the College provide educational support for healthcare in PNG by participating in the Medical Officer, Nursing and Allied Health Project. College Fellows also assist Royal Australasian College of Surgeons/AusAID surgical teams visiting PNG, Fiji and the Pacific Islands, and East Timor. The College provides a Visiting Professor in Anaesthesia and an examiner for the MMed (Anaesthesia) examination at the University of PNG, and awards prizes for the best undergraduate and postgraduate students in anaesthesia. The ANZCA Maintenance of Professional Standards (MOPS) program is available to PNG anaesthetists.

At the Fiji School of Medicine, ANZCA provides an examiner for the MMed (Anaesthesia) examination and awards a prize for the best candidate. The MOPS program is also available to anaesthetists in Fiji.

Australasian College of Dermatologists

College Fellows have participated in AusAID's Pacific Islands Project, conducting clinics in Vanuatu, Samoa, Fiji and Tuvalu. College Fellows have also participated in the AusAID-funded Graduate Training Program at the Fiji School of Medicine.

The College supports the training of African health officers in dermatology at the International League of Dermatological Societies Regional Dermatology Training Centre in Moshi, Tanzania. Past trainees have been from Uganda and Malawi.

Two College Fellows have written a booklet, Skin disease in the Pacific (University of Sydney, 2000), for use in the Pacific Islands, and, in September 2002, two College Fellows conducted a three-day workshop for doctors and nurses in Suva, Fiji.

Royal Australian College of General Practitioners

For over 20 years, the College has run a conjoint examination with the Malaysian Academy of Family Practice, awarding successful candidates the Fellowship of the Royal Australian College of General Practitioners.

The Continuous Home Evaluation of Clinical Knowledge (CHECK) program (a continuing medical education program) is distributed through several developing countries, and it is hoped to extend its reach to incorporate India, Myanmar and Indonesia.

The College has had a long involvement with WONCA (the World Organisation of Family Doctors), especially in the Asia Pacific region. It provides strong support to many of the regional family medicine working groups and furthers WONCA's objectives of promoting tobacco control and prevention and management of HIV/AIDS in the region.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Together with the Pacific Society for Reproductive Health, the College is developing a Continuing Professional Development Program for obstetricians and gynaecologists in Pacific Island countries. The College provides educational input and teaching assistance for the Diploma and Master of Medicine (Obstetrics and Gynaecology) programs at the University of PNG and the Fiji School of Medicine.

The RANZCOG supports young gynaecologists in the Asia and Oceania region to attend reproductive health scientific meetings (including the College's own Annual Scientific Meeting) and short-term training placements in hospitals in Australia and New Zealand.

The College maintains a register of volunteers and responds to requests for locum and teaching placements in major regional hospitals in PNG and Fiji. From time to time, second-hand medical equipment is channelled to these hospitals.

The College provides specialist input for meetings, workshops and health improvement programs run by obstetrics and gynaecology societies throughout Asia and Oceania.

Royal Australian and New Zealand College of Ophthalmologists

The College coordinates Fellows' involvement in developing countries in providing both ongoing services and concentrated, practical training programs for ophthalmologists in these countries. In addition, funds have been allocated to provide university and hospital ophthalmology departments in developing countries with 120 free subscriptions to the College's scientific journal, Clinical and Experimental Ophthalmology.

The College sponsors ophthalmologists from developing countries to attend and participate in the RANZCO's Annual Scientific Congress, and, in 2002, the International Congress of Ophthalmology in Sydney.

A recently acquired laser and other equipment will be available to Fellows for use when working in developing countries, and a travel grant is available for registrars to enable them to attend overseas field trips in developing countries. Registrars have recently worked in Bali, Fiji, Tonga and Western Samoa.

Royal College of Pathologists of Australasia

The College has active training programs in Hong Kong, Singapore and Malaysia, and has representatives from these countries on its Council. Although there are only 25 forensic pathologists in Australia, the College has a number of initiatives in this field. These include:

• responsibility for the Forensic Pathology Secretariat of the World Association of Societies of Pathology;

• initiation of a Diploma in Forensic Medicine designed for overseas graduates who are ineligible for Australasian qualifications;

• training of graduates from Sri Lanka, Kenya, Malaysia, Tanzania, Taiwan and Fiji in forensic pathology institutions around the country;

• assistance with forensic investigations in Bosnia, Kosovo, East Timor and Fiji; and

• establishment of inhouse forensic pathology training at the International Committee of the Red Cross in Geneva (during 2003).

A Soft Tissue Tumour Registry, designed to assist with the diagnosis of soft-tissue tumours, operates at an international level, and includes a number of panellists in China.

Royal Australasian College of Physicians

The College has an Asia Pacific Committee, with members from PNG, Fiji, Malaysia, Singapore, Hong Kong and Thailand. The committee promotes links with the Asia Pacific region, contributes to development projects, undertakes educational initiatives, and maintains a database of activities and College Fellows in the region.

For the past seven years, the College has been the lead partner in a major AusAID-funded training project, the PNG - Medical Officer, Nursing and Allied Health Science Training Project. The project is aimed at strengthening the capacity of the PNG National Department of Health and the University of PNG to improve training in medicine, post-basic nursing and allied health sciences.

The College annually provides visiting lecturers for the Master of Medicine Program in Malaysia and for educational programs in Fiji. It also contributes to other organisations' projects, including projects of the Royal Australasian College of Surgeons in the Pacific Islands and the Fiji School of Medicine.

Royal Australian and New Zealand College of Radiologists

The College is developing a radiology education centre for the South Pacific, based in Fiji, under the guidance of the World Health Organization and in association with international radiology and radiography societies.

New Zealand and Australian radiologists make short visits to Samoa, Vanuatu, Solomon Islands, PNG and Fiji, providing education in image interpretation, management and client focus. The success of the visits is assessed by host country radiologists and radiographers.

South Pacific radiologists are encouraged and financially supported to participate in the annual scientific meetings of the College. Further, the College is establishing a program to provide new, second-hand and superseded radiology textbooks to developing countries. Sources include publishers, radiologists, and practices.

The College supports a number of ongoing collegiate linkages in developing countries, based on providing information and educational resource sharing, as well as organisational and peer support.

A current project involves working with the Cambodian Medical Association to strengthen professional development capacity. Initial work, including familiarisation visits, educational resource development and workshops, has been funded by AusAID.

In the PNG Tertiary Health Services Project, specialist medical teams deliver surgical services that would not otherwise be available. Ongoing links between visiting surgeons and local personnel improve medical knowledge and skills in PNG.

The Pacific Islands Project involves short term visits by specialists from 12 different specialties to 10 Pacific Island countries: the Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Samoa, Solomon Islands, Samoa, Tonga, Tuvalu and Vanuatu. The teams provide clinical service, as well as training for local personnel.

The Medical Equipment Maintenance Project covers seven Pacific Island countries, using formal and on-the-job training to improve equipment management practices, equipment reliability, and technical skills for local personnel.

Interplast is a collaborative effort with Rotary, the Australian and New Zealand College of Anaesthetists and registered nurses to teach and deliver plastic and reconstructive surgical services to developing countries.

This selection shows what is possible when individuals and institutions apply their resources to work in partnerships with countries with greater needs and fewer resources than Australia. It should serve as a challenge to each one of us, as doctors, to ". . . search and see if there is not some place where you may invest your humanity" (Albert Schweitzer).